The Swedish Musculoskeletal team is committed to constantly innovating to find the best treatment options for our patients. The motivation to advance our knowledge about the effective use of orthobiologics is grounded in their potential as less expensive, less invasive and more effective treatment options than the current nonsurgical approaches to treating acute and chronic musculoskeletal injuries.
Regenerative medicine uses cell therapies to create living, functional tissues to repair or replace tissue or organ function lost due to age, disease, damage or congenital defects. An emerging focus of regenerative medicine is musculoskeletal care, which is care for patients with conditions affecting bone, joints, cartilage, meniscus, tendons and ligaments.
Cell therapies are being explored as a means to improve treatments for patients with conditions including:
- Degenerative joint disease
- Tendinopathy (tendinitis and tendinosis)
- Chondral (cartilage) defects
- Plantar fasciitis
- Ligament injuries
The hope is to relieve pain, restore function and improve quality of life for patients suffering from these conditions.
The Swedish Regenerative Medicine program offers two types of cell therapies – platelet-rich plasma (PRP), and bone marrow aspirate concentrate (BMAC) – for patients with musculoskeletal conditions such as degenerative joint disease and osteoarthritis. These cell therapies are also known as “orthobiologics” – substances found naturally in human cells that can be used to help injuries heal more quickly.
Swedish physicians may present these types of treatment alternatives to patients when several other treatment options have failed. Physicians discuss traditional and alternative treatments in full with each patient to ensure they understand their options and receive the best care possible. These treatment options are only considered when physicians and patients agree that the potential benefits outweigh the known risks, such as infection and inflammation.
Bone marrow aspirate concentrate (BMAC) is an orthobiologic derived from a patient’s own bone marrow. BMAC studies have recently shown encouraging results for improved pain and function at 12 months for patients with chronic tendinopathy, chondral defects and osteoarthritis. Several groups have demonstrated that BMAC is safe for patient use and has potential to improve pain and activity level in patients with various knee pathologies (Sources: Hauser and Orlofsky 2013, Centeno et al 2014, Kim et al 2014; Pascual-Garrido et al 2012, Chahla et al 2016, Gobbi et al 2015).
Platelet-rich plasma (PRP) is a concentrate of platelets and plasma proteins derived from whole blood, which is centrifuged to remove red blood cells. Platelets contain hundreds of growth factors that have a role in tissue repair and healing. Although we are stilling learning about PRP, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process (Source: AAOS). Preliminary research in humans is underway.
Surgeons might also use PRP in the treatment of certain fractures and in some knee and hip surgeries.
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